Prospective Student-Athlete Questionnaire

Required

Thank you for your interest in Wilbraham & Monson Academy's Athletic Program.

Please take some time to complete this questionnaire. When completed, this questionnaire will be sent to our Admission Office who will forward it to the coach(es) of your sport/interest and he or she will respond to you as soon as possible.

This information is confidential and will not be used in any other format. This is not a formal application to Wilbraham & Monson Academy. It is used solely to give our coaches some basic information about you.

Student's First Namerequired

Student's Last Namerequired

Male/Female

Student's Date of Birthrequired

(mm/dd/yyyy)

Application for admission to graderequired

For the academic yearrequired

Emailrequired

Telephone Numberrequired

Address 1required

Address 2

Cityrequired

Staterequired

Zip Coderequired

Countryrequired

Height

Weight

Current School:

Namerequired

Multiple Choicerequired

Parochial

Public

Private

Years attendedrequired

Current Graderequired

Addressrequired

Street, City, State, Zip Code, Country

Phone Number

How did you learn about Wilbraham & Monson Academy?required

Please list your sports in order of priority:

Sport 1

Position(s)

Coach's Name

Coach's Phone Number

Coach's Email

Achievements & Statistics

Club/AAU/Select Teams

Coach's Name

Coach's Phone Number

Coach's Email

Are you interested in playing other sports at WMA?

Yes

Unsure

Sport 2

Position(s)

Coach's Name

Coach's Phone Number

Achievements & Statistics

Club/AAU/Select Teams

Coach's Name

Coach's Phone Number

Other Sports Played or School-Related Interests

Additional References

For Questions please contact:

Admission Office
Wilbraham & Monson Academy
451 Main Street
Wilbraham, MA 01095
413.596.9107
admission@wma.us